Dental Hygiene Diagnosis Impact on Treatment Options Diagnosis impact on treatment planning Disease classification distinguishes the various conditions affecting the periodontium and it facilitates treatment planning. Several classifications are used based on clinical manifestations, including: * Location * Degree of tissue change or loss and, * Rate of destruction
Periodontitis can be classified into three major types based on:
Clinical
Radiographic
Historical and
Laboratory characteristics
Classification of periodontal diseases facilitates treatment alternatives and therapeutic outcomes. Chapter 7, pages 101 - 108, has quick references of the classifications of periodontal diseases and conditions. In general these diseases fall into three broad categories: 1. Gingival diseases 2. Various types of periodontitis 3. Periodontal manifestations of systemic diseases
Proper diagnosis of periodontal disease determines:
Identify type
Extent
Distribution
Severity and
Provides understanding of cause & pathologic process
To obtain the diagnosis, the dental hygienist must analyze and evaluate the patient’s:
Case history
Clinical signs & symptoms
Results of various tests (probing, mobility, radiographs, blood tests, & biopsies.)
Findings must correlate and provide meaning for the patient (role of systemic diseases, conditions, behavioral factors. Does the patient require tx modifications and special precautions.)
Tools for Determining Diagnosis: 1. Overall appraisal of patient 2. Medical history & Risk Assessment (patient & family hx) 3. Dental history (patient & family hx) 4. Radiographic interpretation 5. Casts 6. Clinical photographs 7. Extra & Intra Oral examination 8. Periodontal examination & Prognosis 9. Nutritional status 10. Laboratory tests
ALL of these combined are what make an IMPACT on treatment planning; on the ability of the dental hygienist to treatment plan effectively and have it be patient centered. What happens next after the DIAGNOSIS is made? The dental hygienist has the ability to provide a patient centered treatment plan that is customized to their oral health needs.
The Treatment Plan:
Blueprint for case management
Procedures required to establish and maintain oral health
Treatment encompasses therapeutic objectives according to patient oral health needs; based on diagnosis, disease severity, and other factors.
Reasoned decision
Techniques to reach objective
The goal of the treatment plan is to eliminate gingival inflammation and correct the conditions that cause and perpetuate it.
Considerations for treatment planning:
Extracting or preserving teeth. Removal, retention, of temporary retention of one or more teeth is important for the overall tx plan. Proper function and esthetics are important, may require interdisciplinary consultation with specialists.
Occlusal relationship, systemic conditions, and supportive periodontal care
Therapeutic Procedures Phase I – nonsurgical phase Phase II – surgical phase Phase III – restorative phase Phase IV – maintenance phase
Explaining the treatment plan to the patient: 1. Be specific, explain exactly what conditions are & how they are treated, & prognosis after tx. 2. Begin discussion on a positive note. Long-term service expected and every effort will be made to retain as many teeth as possible. 3. Present the entire tx plan as a unit. Do not let the pt assume that there are procedures that they can pick and choose to do or not do. 4. Explain that not taking action and not proceeding with proposed tx plan is unadvisable. Emphasize the importance of eliminating disease and that maintaining disease may have severe life-threatening risk factors, such as cardiovascular disease, pulmonary disease and stroke.
Diagnosis impact on treatment planning
Disease classification distinguishes the various conditions affecting the periodontium and it facilitates treatment planning. Several classifications are used based on clinical manifestations, including:
* Location
* Degree of tissue change or loss and,
* Rate of destruction
Periodontitis can be classified into three major types based on:
Classification of periodontal diseases facilitates treatment alternatives and therapeutic outcomes. Chapter 7, pages 101 - 108, has quick references of the classifications of periodontal diseases and conditions. In general these diseases fall into three broad categories:
1. Gingival diseases
2. Various types of periodontitis
3. Periodontal manifestations of systemic diseases
Proper diagnosis of periodontal disease determines:
To obtain the diagnosis, the dental hygienist must analyze and evaluate the patient’s:
Tools for Determining Diagnosis:
1. Overall appraisal of patient
2. Medical history & Risk Assessment (patient & family hx)
3. Dental history (patient & family hx)
4. Radiographic interpretation
5. Casts
6. Clinical photographs
7. Extra & Intra Oral examination
8. Periodontal examination & Prognosis
9. Nutritional status
10. Laboratory tests
ALL of these combined are what make an IMPACT on treatment planning; on the ability of the dental hygienist to treatment plan effectively and have it be patient centered.
What happens next after the DIAGNOSIS is made? The dental hygienist has the ability to provide a patient centered treatment plan that is customized to their oral health needs.
The Treatment Plan:
The goal of the treatment plan is to eliminate gingival inflammation and correct the conditions that cause and perpetuate it.
Considerations for treatment planning:
Therapeutic Procedures
Phase I – nonsurgical phase
Phase II – surgical phase
Phase III – restorative phase
Phase IV – maintenance phase
Explaining the treatment plan to the patient:
1. Be specific, explain exactly what conditions are & how they are treated, & prognosis after tx.
2. Begin discussion on a positive note. Long-term service expected and every effort will be made to retain as many teeth as possible.
3. Present the entire tx plan as a unit. Do not let the pt assume that there are procedures that they can pick and choose to do or not do.
4. Explain that not taking action and not proceeding with proposed tx plan is unadvisable. Emphasize the importance of eliminating disease and that maintaining disease may have severe life-threatening risk factors, such as cardiovascular disease, pulmonary disease and stroke.